A mathematical model of the intramyocardial coronary microcirculation is used to explore the validity of a fast CT imaging method for characterizing the myocardial microcirculatory functional status. The fast CT method depends on the demonstrated CT-based estimation of myocardial perfusion (F) and the intramyocardial blood volume (B(v)). The observed curvilinear myocardial blood volume-to-flow relationship, empirically fitted to B(v) = a.F + b.F(0.5), is a signature of the underlying early pathophysiologic processes thought to be involved in systemic disease processes, such as atherosclerosis, hypertension, and diabetes mellitus. The sensitivity and specificity of the CT-based estimate of this characteristic relationship is explored by altering the characteristics of the vascular diameter-to-flow relationship and the variation in the fraction of capillaries perfused at different coronary flows. The simulation results also indicate that if the vascular diameters change so that the vascular resistance corresponds to the change in flow, then the empirically observed myocardial B(v)-to-F relationship holds well.
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http://dx.doi.org/10.1111/j.1749-6632.2002.tb04589.x | DOI Listing |
Crit Care
January 2025
División de Terapia Intensiva, Hospital Juan A. Fernández, Buenos Aires, Argentina.
The advancements in cardiovascular imaging over the past two decades have been significant. The miniaturization of ultrasound devices has greatly contributed to their widespread adoption in operating rooms and intensive care units. The integration of AI-enabled tools has further transformed the field by simplifying echocardiographic evaluations and enhancing the reproducibility of hemodynamic measurements, even for less experienced operators.
View Article and Find Full Text PDFComplete myocardial revascularization, targeting both culprit and non-culprit coronary stenoses, is recommended by current guidelines in acute myocardial infarction (AMI) management, either during the index percutaneous coronary intervention (PCI) procedure or within 45 days, depending on the clinical context. However, in patients with chronic kidney disease (CKD), particularly end-stage kidney disease (ESKD), fractional flow reserve (FFR) presents unique challenges. Altered coronary physiology in CKD, such as arterial stiffness and microcirculatory dysfunction, affects FFR accuracy, complicating revascularization decisions.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Oxford Heart Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
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